| Grande Ronde Child Center, Inc. | |
|
902 D Ave La Grande OR 97850-1970 | |
| (541) 963-8666 | |
| Not Available |
| Full Name | Grande Ronde Child Center, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 902 D Ave, La Grande, Oregon |
| Authorized Official Name and Position | Jim Sheehy (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5419638666 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grande Ronde Child Center, Inc. 902 D Ave La Grande OR 97850-1970 Ph: (541) 963-8666 | Grande Ronde Child Center, Inc. 902 D Ave La Grande OR 97850-1970 Ph: (541) 963-8666 |
| NPI Number | 1639232069 |
|---|---|
| Provider Enumeration Date | 12/18/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639232069 | NPI | - | NPPES |
| 234855 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Oregon) | Primary |
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